Provider Demographics
NPI:1457770620
Name:NUOMAN, ROLLA
Entity type:Individual
Prefix:
First Name:ROLLA
Middle Name:
Last Name:NUOMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 KING ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-3458
Mailing Address - Country:US
Mailing Address - Phone:508-847-6687
Mailing Address - Fax:
Practice Address - Street 1:755 N BROADWAY STE 540
Practice Address - Street 2:
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591
Practice Address - Country:US
Practice Address - Phone:914-358-0188
Practice Address - Fax:914-358-0189
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2757102084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology